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Aneurysm of Upper Limb Arteries in Children: Report of Five Cases
Ildar Nurmeev1,2, Dmitry Osipov2, Bruce Okoye3
1Department of Pediatric Surgery, Kazan Medical University, Kazan, Russia.
Insights
Pediatric upper limb aneurysms are rare but successfully treated with surgery. This case series highlights effective surgical interventions for brachial and radial artery aneurysms in children, ensuring arterial patency.
Area of Science:
- Vascular Surgery
- Pediatric Surgery
- Aneurysm Research
Background:
- Arterial aneurysms in children are uncommon, presenting unique diagnostic and therapeutic challenges.
- This study focuses on upper limb arterial aneurysms in pediatric patients, a rare clinical entity.
Observation:
- A case series of five children (median age 3.3 years) with brachial or radial artery aneurysms is presented.
- Etiologies included idiopathic, connective tissue dysplasia, and trauma; most were true aneurysms.
- Diagnosis utilized ultrasound and arteriography, guiding surgical planning.
Findings:
- Surgical treatment involved aneurysm resection with various reconstruction methods, including ligation, end-to-end anastomosis, and graft interposition (PTFE and autoveous).
- One case of PTFE graft dysfunction necessitated reoperation with an autoveous graft, demonstrating potential complications.
- Successful restoration of arterial patency was achieved in the majority of cases.
Implications:
- Timely and appropriate surgical intervention in specialized centers can lead to successful outcomes for pediatric upper limb aneurysms.
- This research contributes to understanding the management of rare pediatric vascular conditions.
- Further investigation into long-term outcomes of different reconstructive techniques is warranted.
Background:
Arterial aneurysm in children is rare.
Aim:
To present the description of case series of successful surgical treatment of upper limb aneurysms in children. The case series included 2 boys and 3 girls, with median age 3.3 years. One of them was a newborn with a true brachial artery aneurysm. Aneurysms were in the brachial (n = 3) and radial (n = 2) arteries. Two patients had idiopathic aneurysms. Two cases were associated with connective tissue dysplasia syndrome. One patient had a history of trauma. In 4 of 5 cases, there was a true aneurysm and in one a pseudoaneurysm. Diagnosis was carried out in all cases by using ultrasound, with arteriography in one case. All 5 children were operated on. Resection of the aneurysm and restoration of arterial patency was performed in 4 of 5 cases (ligation of the radial artery near the aneurysm in 1 case, aneurysm resection with end-to-end anastomosis in 1 case, resection with PTFE graft implantation in 1 case, and resection with implantation of an autovenous graft in 2 cases. Complications. Dysfunction and thrombosis of the PTFE graft required reoperation using an autovenous graft.
Conclusion:
Despite the rarity of the disease, timely and adequate surgical treatment of aneurysms of the arteries of the upper extremities in children is possible successfully in a specialized hospital.
